Long-term results of lower limb lengthening by the Wagner method

Methods of limb lengthening have been continuously modified. The construction of an apparatus for gradual bone distraction was a great improvement. The aim of this study was to evaluate the long-term results of lower limb elongation using the Wagner technique. Between 1983 and 1989, 45 patients underwent surgery in the authors' institution. There were 31 femoral and 15 tibial lengthenings. The operation and lengthening procedure were performed according to the rules published by the method's author. The intended amount of lengthening was achieved in 80% of patients during tibial elongation and in only 52% during femoral elongation because of many problems, obstacles, and complications during treatment. A significant percentage of improper (deficient or irregular) new bone formation led to femoral malunion in three patients and to tibial and femoral delayed bone consolidation in six patients. Fast distraction produced great forces on the surrounding joint surfaces, resulting in a limited range of motion and joint stiffness. The Wagner technique does not seem to be effective and is associated with a long duration of treatment and some complications impairing the function of the limb.